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Critical Care
Published in: Critical Care 1/2016

Open Access 01-12-2016 | Letter

Is it time to combine untargeted antifungal strategies to reach the goal of ‘early’ effective treatment?

Authors: Andrea Cortegiani, Vincenzo Russotto, Santi Maurizio Raineri, Antonino Giarratano

Published in: Critical Care | Issue 1/2016

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Excerpt

A recently published retrospective study by Posteraro et al. [1] investigated the use of (1–3)-β-d-glucan (BDG) as a strategy for antifungal drug administration in patients at high risk of candidemia. The strategy consisted of the administration of antifungals (anidulafungin in most cases) to septic patients with a Candida score ≥ 3 and a positive BDG result (≥80 pg/ml). This untargeted strategy led to better selection of patients, avoiding exposure to antifungals in approximately 73 % of patients with negative BDG results and leading to shortened treatment duration in another 20 % of patients. …
Literature
1.
Posteraro B, Tumbarello M, De Pascale G, Liberto E, Vallecoccia MS, De Carolis E, Di Gravio V, Trecarichi EM, Sanguinetti M, Antonelli M. (1,3)-β-d-Glucan-based antifungal treatment in critically ill adults at high risk of candidaemia: an observational study. J Antimicrob Chemother. 2016;71:2262–69 
2.
Calandra T, Roberts JA, Antonelli M, Bassetti M, Vincent J-L. Diagnosis and management of invasive candidiasis in the ICU: an updated approach to an old enemy. Crit Care. 2016;20(1):125.CrossRefPubMedPubMedCentral
3.
Cortegiani A, Russotto V, Maggiore A, Attanasio M, Naro AR, Raineri SM, Giarratano A. Antifungal agents for preventing fungal infections in non-neutropenic critically ill patients. Cochrane Database Syst Rev. 2016;1:CD004920.PubMed
4.
5.
Nucci M, Nouér SA, Esteves P, Guimarães T, Breda G, Miranda BG de, Queiroz-Telles F, Colombo AL. Discontinuation of empirical antifungal therapy in ICU patients using 1,3-β-d-glucan. J. Antimicrob Chemother. 2016;dkw188. doi:10.​1093/​jac/​dkw188.
Metadata
Title
Is it time to combine untargeted antifungal strategies to reach the goal of ‘early’ effective treatment?
Authors
Andrea Cortegiani
Vincenzo Russotto
Santi Maurizio Raineri
Antonino Giarratano
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2016
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-016-1404-4

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